Clinical features, management strategies, and visual acuity outcomes of Candida endophthalmitis following cataract surgery.

BACKGROUND AND OBJECTIVE To report the clinical features, management, and visual outcome in patients with Candida endophthalmitis following cataract surgery. PATIENTS AND METHODS The Bascom Palmer Eye Institute Microbiology Laboratory database and corresponding medical records were reviewed from 1980 to 2006. RESULTS Five patients were identified. Endophthalmitis developed 7 to 60 days postoperatively (median, 14 days). Presenting visual acuity was 20/200 to counting fingers and final visual acuity was 20/25 to light perception. Whitish material was noted on the intraocular lens or lens capsule (4 of 5) or within the cataract wound (1 of 5). All patients received intravitreal amphotericin B and more than one pars plana vitrectomy procedure; four received systemic antifungal agents and four underwent intraocular lens removal. CONCLUSIONS Given whitish material on the intraocular lens, lens capsule, or cataract wound, Candida should be included in the differential diagnosis of early- or delayed-onset endophthalmitis following cataract surgery. Initial pars plana vitrectomy and intravitreal and oral antifungal medications may not achieve infection resolution. Intraocular lens explantation may assist in organism eradication.

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